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Do Opioids Cause Headaches?

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Aug 14, 2023 • 6 cited sources

While opioids don’t seem to cause headaches in most people, they can worsen headaches in those that already have them.

Opioids like Vicodin and OxyContin come with plenty of side effects. Nausea and constipation are the most common, but some people experience dizziness too.[1] 

Migraines are chronic headaches that cause crippling pain and unusual visual and audible sensations. Nausea during migraines is common too. 

When people with significant migraines go to the hospital for help, they’re often given opioids. Unfortunately, using these medications repeatedly to address migraines can make the pain worse and the headaches more frequent.

If you have migraines, talk with your doctor about non-opioid treatment options that can solve (not mask) the problem. 

Why Do Opioids Cause Headaches?

Opioids are prescription painkillers, and they should be effective forms of pain control. But researchers say using them too often can cause damage that leads to more headache episodes.

The science is complicated, but essentially, researchers say that pain pathways grow stronger when opioids are used chronically.[2] People accustomed to regular use of opioid drugs feel pain more acutely, and they develop migraines more often. Their pain becomes even harder to control, since their pathways are so attuned to pain sensations. 

Who Is More Likely to Get Headaches From Opioids?

People with a history of migraines, and who have used opioids to treat them in the past, are at high risk of developing opioid-related headaches. Unfortunately, many people fall into this category. 

Researchers say more than 36% of people with migraines keep opioids on hand for treatment.[3] Each time they lean on these drugs, they increase the likelihood that they’ll develop an opioid-related headache. 

Recurring headaches are more common in the following groups:

  • Women
  • People with sedentary lifestyles 
  • People with a high body mass index
  • Those who have underlying pain conditions

Anyone can develop repeating headaches that might be exacerbated by regular use of opioid medications. But those with migraines who fit into these groups have a higher risk. 

How to Stop Headaches From Opioids

Many doctors use opioids as front-line medicine. More than 50% of emergency room visits for migraines end with an opioid prescription.[4] But these aren’t the best way to treat these debilitating headaches.

Ask your doctor about migraine-specific therapies like triptans.[5] These drugs can help to calm biological processes that lead to migraines, stopping them from progressing into debilitating pain. However, caution is warranted, because these medications can also be overused. People using these medications more than 10 times per month sometimes suffer from rebound headaches. Newer drugs can potentially help patients for whom triptans are not effective at minimizing migraine episodes.[6] 

Track your migraine frequency and severity, and if your new medications aren’t helping, tell your doctor. You may need to adjust your dose a few times until you find the mixture that’s right for you and your body. 

Stop Opioid Misuse

It’s easy to begin taking opioids outside the parameters of a prescription if you are taking them to deal with pain. If you are unable to stop opioid misuse on your own, it’s a sign that you may have an opioid use disorder. 

Reach out for help, which often involves the use of Medication for Addiction Treatment, so you can stop misusing opioids. Part of your comprehensive treatment plan will involve addressing co-occurring conditions, like headaches. 

With the right treatment approach, you can manage your headaches without opioid misuse. This is all part of a path to a better life for you.

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. Opioid Complications and Side Effects. Pain Physician. March 2008. Accessed March 2023.
  2. Medication Overuse Headache is a Manifestation of Opioid-Induced Hyperalgesia: A Neruoimmune Hypothesis and Novel Approach to Treatment. The Journal of Headache and Pain. February 2013. Accessed March 2023.
  3. Characterizing Opioid Use in a U.S. Population with Migraine. Neurology. August 2020. Accessed March 2023.
  4. Opioids and Migraine. American Headache Society. Accessed March 2023.
  5. Comparison of New Pharmacologic Agents With Triptans for Treatment of Migraine: A Systematic Review and Meta-Analysis. JAMA. October 2021. Accessed March 2023.
  6. Therapeutic Novelties in Migraine: New Drugs, New Hope? The Journal of Headache and Pain. April 2019. Accessed March 2023.

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